肝小静脉闭塞病5例并文献分析

Five cases of hepatic veno-occlusive disease and literature analysis

目的分析肝小静脉闭塞病的临床特点、影像表现和诊治经验。方法回顾性分析2005年1月～2011年1月我院收治的5例肝小静脉闭塞病患者的临床资料。结果根据临床及病理学资料，将肝小静脉闭塞病分为急性期（1例）、亚急性期（1例）和慢性期（3例）。CT平扫检查均发现肝脏肿大，肝实质密度降低。彩色B超检查均发现肝静脉变细，血流变缓；4例患者存在腹水。行门一体分流术3例，其中好转2例，死亡1例。行内科保守治疗2例，其中1例治愈，1例好转。结论肝小静脉闭塞病临床表现以肝脏肿大和腹水为特征。影像学检查对肝小静脉闭塞病诊断有重要价值。急性期患者宜采取内科保守治疗，若出现门脉高压症状时，应行门一体分流术治疗。

Objective To investigate the clinical featuers,imaging characteristics,diagnosis and treatment experience of hepatic veno-occlusive disease（HVOD）. Methods The clinical data of five patients with HVOD admitted to Renmin Hospital of Wuhan Univeristy during January 2005 to January 2011 were retrospectively analyzed. Results According to the results of clinical and pathological data,5 patients with HVOD were divided into acute progressive HVOD（ 1 patient） ,subacute HVOD（ 1 patient） and chronic HVOD（3 patients）. Hepatomegaly and reduced liver parenchyma were detected by CT scan. Thin- ner hepatic vein and slower blood flow were found by B-mode ultrasound scan（BUS） , and ascites was de- tected in 4 patients. Of 3 patients received portosystem shunt,2 cases improved, and 1 case died. 2 patients with medical conservative treatment got better. Conclusion Clinical manifestations of HVOD is charac- terized by hepatomegaly and ascites. Imaging examination is valuable for the diagnosis of HVOD. Acute patients in acute stage should receive conservative treatment,and portosystem shunt should be performed in patients with portal hypertension.